Vol 27, No 3 (2023)

Congenital toxoplasmosis is a consequence of acute toxoplasmosis in a pregnant woman. When assessing the risk of сongenital toxoplasmosis during pregnancy, methods for determining specific antibodies, the genetic material of the pathogen (polymerase chain reaction method), immunoglobulins G avidity are used. Molecular genetic methods have the greatest diagnostic value in the diagnosis of сongenital toxoplasmosis in children of the first year of life. Drug prevention of сongenital toxoplasmosis in Russia can be implemented with the use of spiramycin, antenatal therapy is impossible, and postnatal therapy is limited by the list of available antiprotozoal drugs. For the prevention of сongenital toxoplasmosis, the awareness of the population about the ways and factors of transmission of the pathogen is of primary importance.

BACKGROUND: Arterial hypertension is a common cardiovascular disease that requires constant monitoring by a doctor of drug therapy to achieve the target blood pressure level.

AIM: To analyze pharmacotherapy of essential hypertension in patients, who have achieved a controlled course of the disease.

MATERIALS AND METHODS: In this study 274 patients with controlled course of stage 2 arterial hypertension and no comorbidities were recruited. Blood pressure indicators, anthropometric data, results of laboratory and instrumental studies, the volume of drug therapy for hypertension were analyzed.

RESULTS: We analyzed 543 drug prescriptions for 274 patients with stage II hypertension. In 97 (35.3%) patients only one drug was prescribed, in 112 (40.7%) — two drugs, in 46 (16.7%) — three drugs from various pharmacological groups, among which monodrugs were in the lead: angiotensin-converting-enzyme inhibitors — 31.86%, cardioselective β-blockers — 23%, angiotensin 2 receptor blockers — 9.3%. Combined drugs were present in 18.4% of general doctors’ prescriptions. Fixed forms of combined antihypertensive drugs were taken by only 50 (18.4%) patients. To prevent cardiovascular complications of arterial hypertension, 75 (26%) patients were prescribed statins (atorvastatin or rosuvastatin) and 56 (19.5%) — antiplatelet monotherapy with Cardiomagnyl, Thrombo ACC or clopidogrel.

CONCLUSIONS: To achieve the target blood pressure level and control arterial hypertension in patients with stage II hypertension, general practitioners used all main

BACKGROUND: The number of people with multimorbidity has been steadily increasing in recent years. In patients with bronchial asthma, the level of control and cytokine profile with markers of fat metabolism may depend on body mass index and the presence of multimorbidity.

AIM: To assess the relationships of disease control level, cytokine profile, adiponectins and oxidant stress level in asthma patients depending on body mass index and multimorbidity

MATERIALS AND METHODS: Patients with asthma (n = 237) were divided into 3 groups depending on body mass index. We analyzed multimorbid pathology, assessed asthma control according to Asthma Control Questionnaire-5; determined interleukin-6, -4, resistin, tumor necrosis factor-alpha, degree of oxidative damage to biomolecules, antioxidant capacity of serum, leptin, adiponectin levels. Statistical analysis: Microsoft Excel, Statistica 12.0, Statgraphics XVIII.

RESULTS: There were significantly more (p < 0.05) comorbidities among the obese and asthma patients. The levels of leptin, resistin, interleukin-6, tumor necrosis factor-alpha, and degree of oxidative damage to biomolecules were significantly higher in the obese group. Direct correlations were found between body mass index, cumulative pathology rating scale, Asthma Control Questionnaire-5 and interleukin-6, tumor necrosis factor-alpha, degree of oxidative damage to biomolecules, leptin, and resistin control levels of asthma. An inverse correlation with adiponectin was detected with body mass index.

CONCLUSIONS: Authentic increase of adipokins and anti-inflammatory cytokines, oxidative stress indexes and decrease of anti-inflammatory effects of adiponectin are noted in patients with asthma and obese patients. Multimorbidity further contributes to the development of systemic inflammation in patients with asthma. Obesity and multimorbidity are factors complicating the achievement of asthma control.

Calcifylaxis — calcifying uremic arteriolopathy — is a rare disease that occurs in patients with chronic kidney disease and is characterized by progressive calcification of small-caliber skin vessels and thrombosis of small (arterioles), accompanied by necrosis of the skin, subcutaneous tissue and soft tissues with severe pain syndrome. The article describes a patient with a long-term, severe course of diabetes mellitus, the development of diabetic nephropathy with an outcome in terminal renal failure, which required renal replacement therapy with peritoneal dialysis and kidney transplantation. In the posttransplantation period, the patient registered the occurrence of calcifylaxis, which is a rare complication.

The lack of treatment protocols for calcifylaxis in patients with chronic kidney disease requires further research. It is important to constantly monitor patients with risk factors for the development of this serious disease and timely treatment, which will improve their condition and slow down the progression of the process.